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OREGON HEALTH LICENSING AGENCY
OREGON HEALTH LICENSING AGENCY
DIVISION 420
PRACTICE STANDARDS
331-420-0000
Practice Standards
Licensed denturists shall adhere to the following practice standards:
(1) Oral Health Certificate. Denturists must either have an oral pathology endorsement on their license, or if they have not qualified for and received the endorsement, must comply with requirements for obtaining an Oral Health Certificate as described in ORS 680.545 and OAR 331-410-0080.
(2) Patient Documentation. Licensed denturists must record, update and maintain documentation for each patient relevant to health history, clinical examinations and treatment, and financial data. Documentation shall be written or computerized. Records should include the following information:
(a) Patient data, including name, address, date and description of examination;
(b) Evidence of informed consent (may be in the form of an acronym such as "PARQ" to denote procedure, alternatives, risks and questions);
(c) Date and description of treatment or services rendered, and any treatment complications;
(d) Health history as applicable; and
(e) Any other information deemed appropriate to patient care.
(3) Clinical Examination. Licensed denturists must conduct and record a clinical examination of each patient that will include at a minimum, information relative to:
(a) Appearance of gingiva, oral mucosal membranes, pharynx, tongue and all other oral soft tissue; and
(b) Oral conditions that may affect successful denture construction and use.
(4) Record Retention. Patient documentation, written or archived electronically by computer, must be retained for a minimum of seven years and available upon request by the agency.
(5) Minimum Standards of Acceptable Patient Care. Licensees must adhere to the following practice standards in rendering acceptable patient care:
(a) Maintain accurate patient records;
(b) Provide goods and services within a reasonable amount of time;
(c) Seek consultation/referral if indicated;
(d) Make accurate representation to the patient on services or denture functionality;
(e) Provide or arrange for continuity of care or emergency treatment for a patient currently receiving treatment;
(f) Employ current denture technology practices and materials;
(g) Adhere to appropriate use of quality materials;
(h) Adhere to Centers for Disease Control infection control standards and the Board's clinical requirements;
(i) Provide a copy of the patient record in a reasonable amount of time for a reasonable amount of money as requested by the patient.
(6) Minimum Standards of Acceptability for Full Dentures: Licensees must adhere to the following practice standards in constructing full dentures that provide appropriate function. Acceptability is measured against the following criteria:
(a) The maxillary denture covers the entire hard palate, with a postdam that extends from the hamular notch to form a posterior seal on the soft palate;
(b) The mandibular denture has full posterior flanges, extending near the floor of the mouth and extending distally to include a portion of the retromolar pad;
(c) The denture base material adapts to the soft tissues and the extension achieves stability;
(d) Tooth position, size, and shade appear natural;
(e) Contour and shade of the denture base material appear natural;
(f) Centric relation, if not correct, is correctable;
(g) Vertical dimension is within the physiologic tolerance of the patient;
(h) No occlusal interferences are present in lateral and protrusive excursions;
(i) Occlusal surfaces have anatomic or nonanatomic detail, and masticatory forces are evenly distributed;
(j) Occlusal disharmony is not present; and
(k) There may not be movement of the denture when biting pressure is applied in anterior and posterior segments of the arch except when it is not reasonably possible to achieve the desired result.
(7) Any deviation from the standards outlined in subsection (6)(a) through (k) of this rule, must be based on the patient's individual physiology, in the best interest of the patient, and in conformance with generally accepted standards of patient care. On such occasion, the denturist must document the reasons for the deviation in the patient record. Failure to document the reasons for deviation from stated standards creates a presumption that the deviation was not in the best interest of the patient.
(8) Violation of Standards. Violation of any practice standard in OAR 331-420-0000 shall constitute grounds for discipline.
Stat. Auth.: ORS 676.605, 676.615, 680.550, 680,565
Stats. Implemented: ORS 676.605, 676.615, 680.550, 680,565
Hist.: HD 4-1988, f. & cert. ef. 3-4-88; HD 4-1989, f. & cert. ef. 6-1-89; HD 13-1991(Temp), f. & cert. ef. 9-30-91; HD 3-1992, f. & cert. ef. 3-25-92; Subsections (9)(a) through (h) renumbered to 333-020-090 and 333-020-100; HD 22-1993, f. 12-30-93, cert. ef. 1-1-94; HDLP 3-1998, f. 6-26-98, cert. ef. 7-1-98, Renumbered from 333-020-0085; HLO 1-2003, f. 1-21-03, cert. ef. 2-1-03; HLO 2-2004, f. 6-29-04, cert. ef. 7-1-04
331-420-0010
Business Premise Requirements
The clinical procedures of denture technology shall be conducted in business premises that meet the following criteria:
(1) All areas of the business premises where denture technology is practiced shall be kept clean and in good repair.
(2) Denturists shall be subject to all Oregon Department of Human Services, Health Services and other city, county, state and federal regulations pertaining to public health and safety. Compliance with building, state fire, plumbing and electrical regulations is required.
(3) When an employee/employer relationship exists, denturists shall comply with ORS 654 and the Oregon Safe Employment Act, and adhere to all Oregon Occupational Safety and Health Codes (OR-OSHA), and Centers for Disease Control (CDC) infection control standards.
(4) Pets or other animals shall not be permitted in the business premises. This prohibition does not apply to registered therapy animals, trained guide animals for the disabled, sightless or hearing impaired, or fish in an aquarium.
[Publications: Publications referenced are available from the agency.]
Stat. Auth.: ORS 680.550 & ORS 680.565
Stats. Implemented: ORS 680.550 & ORS 680.565
Hist.: HD 13-1991(Temp), f. & cert. ef. 9-30-91; HD 3-1992, f. & cert. ef. 3-25-92; Renumbered from 333-020-085(9)(a) through (h); HD 22-1993, f. 12-30-93, cert. ef. 1-1-94; HDLP 3-1998, f. 6-26-98, cert. ef. 7-1-98, Renumbered from 333-020-0090; HLO 1-2003, f. 1-21-03 cert. ef. 2-1-03
331-420-0020
Clinical Requirements
The Board will consider current Centers for Disease Control guidelines when determining acceptable patient care and requirements for the clinical practice of denture technology. Additionally, denturists must comply with the following standards:
(1) Instruments, implements, supplies and impression trays used in intra-oral procedures that come in contact with body fluids shall be sterilized prior to each use.
(2) Instruments or other equipment which are "heat-sensitive" shall be disinfected by complete immersion of the object(s) or portion(s) thereof to be disinfected, in an FDA approved chemical sterilent, and used according to the manufacturer's instructions.
(3) Mechanical sterilizing devices shall be tested for functionality on a quarterly basis by means of a biological monitoring system that indicates the destruction of micro-organisms, and chemical indicators (color change) to assure sufficient temperature and correct functioning of equipment during each sterilization cycle.
(4) Chemical and biological test results shall be available at the business premises at all times for inspection by the Health Licensing Office enforcement officers. Biological test results must be on laboratory letterhead and must contain the test date, and the name, model and serial number of the unit tested. Biological test results shall be retained for a two year period.
(5) Environmental surfaces that are contaminated by blood or saliva shall be disinfected with a high-level disinfectant, which is tuberculocidal and labeled accordingly, or bleach solution, used according to manufacturer's instructions.
(6) Disposable gloves shall be worn whenever placing fingers into the mouth of a patient or when handling blood or saliva contaminated instruments or equipment. Hands shall be washed and re-gloved before performing procedures on another patient.
(7) All contaminated wastes and sharps shall be disposed of according to governmental requirements, specifically ORS 459.386 through 459.405 and OAR 333-056-0020. "Sharps" means any object that can penetrate the skin, including but not limited to needles, scalpel blades, lancets, glass tubes, or other instruments that could be broken during handling, and syringes that have been removed from their original sterile containers.
(8) All procedures performed shall be in such a manner as to avoid cross contamination of blood borne pathogens.
Stat. Auth.: ORS 676.605, 676.615, 680.550, 680,565
Stats. Implemented: ORS 676.605, 676.615, 680.550, 680,565
Hist.: HD 3-1992, f. & cert. ef. 3-25-92; Renumbered from 333-020-085(9)(a) through (h); HD 22-1993, f. 12-30-93, cert. ef. 1-1-94; HDLP 3-1998, f. 6-26-98, cert. ef. 7-1-98, Renumbered from 333-020-0100; HDLP 1-2001, f. 3-21-01, cert. ef. 4-1-01; HLO 1-2003, f. 1-21-03, cert. ef. 2-1-03; HLO 2-2004, f. 6-29-04, cert. ef. 7-1-04
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